{
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"FirstLinePracticeLocationAddress": "5575 WARREN PKWY STE 208",
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"EnumerationDate": "03/31/2009",
"LastUpdateDate": "02/22/2020",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}